CREDIT APPLICATION

If you are interested in financing, please take the time to fill out our online finance application. This application is safe, secure and confidential.

You can also apply in store

Name FIRST / MIDDLE

First Name

Last Name

What bike are you interested in?

Date of birth

YYYY

Social Security Number

Drivers License Number

Drivers License State

Driver's License Expiration date

YYYY

Cash down payment

Requested Term

Monthly

Marital status

Home phone

(###)

###

####

Email address

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Residential Status

Monthly Rent or Mortgage payment

Years at current address

If you've lived at your current address for less than two years, please provide your previous address information.

Previous address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Years at previous address

Employer

Employer phone

(###)

###

####

Position

Employer Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Years Employed

Gross income

Income Frequency

Previous Employer

Previous employer address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Previous employer phone

(###)

###

####

Years at Previous Employer

Reference Name

First Name

Last Name

Reference Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Reference Phone

(###)

###

####

Reference Relation

Do you have a checking account?

Yes

Do you have a savings account?

Yes

Do you have any comments or other information we should consider with the information included with this application?

Entering your name below constitutes your signature, and confirms that: 1) You are submitting this Application for the purpose of applying for a loan and affirms that the information furnished in this Application is true, complete, and correct. 2) You authorize us to request consumer reports from consumer-reporting agencies and information from credit references and other sources disclosed by you in considering this Application and subsequently in order to update, review, renew, extend, or collect the credit we approve. Upon your request, we will inform you of the name and address of each consumer-reporting agency from which we obtained a consumer report on you. 3) Married applicants may apply for an individual loan. 4) You represent that this loan will be used only for personal, family or household purposes. Typing your name below constitutes your signature and authorizes the processing of your Application.

Signature

First Name

Last Name

Signature Date

YYYY

Name FIRST / MIDDLE

First Name

Last Name

Date of birth

YYYY

Social Security Number

Drivers License Number

Drivers License State

Driver's License Expiration date

YYYY

Cash down payment

Marital status

Home phone

(###)

###

####

Email address

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Residential Status

Monthly Rent or Mortgage payment

Years at current address

Employer

Employer phone

(###)

###

####

Position

Employer Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Years Employed

Gross income

Income Frequency

Other Income

Other income source

Do you have any comments or other information we should consider with the information included with this application?

Signature

First Name

Last Name

Signature Date

YYYY

CREDIT APPLICATION

If you are using a co-applicant they need to fill out the form below.

Dynamic Dirt Suspension

Sportsman Cycle Sales